Vacuum treatment for erectile dysfunction

In 1996 a system called MUSE (Medicated Urethral System for Erection) was developed that makes it possible to apply alprostadil through the urethra without the need for an injection. Using a suitable device, a tiny suppository (1 x 3 mm) is introduced into the urethra and the medication is absorbed through the urethral mucosa and from there passes to its activation site, the corpora cavernosa (fig. E).

The doses used are 250, 500 and 1000 micrograms and the erectile effect appears 15-30 minutes later and lasts for about one hour. Fifty percent of the patients respond well to this form of treatment. The most frequent side effect is penile pain in 30% of the patients and very mild urethral bleeding in 5% of the cases. Only 5-6% of the women had vaginal burning. A condom must be used in sexual relations with pregnant women.